2002, Number 3
Acta Ortop Mex 2002; 16 (3)
Treatment for chronic wounds with ulceration by small intestine submucosa. Report of 20 cases
Olivares-Escutia J, Delbouis-Molina AL, Fernández-Mezo JN, Escalante-Magańa JR, López-Ramos M, Sandoval-Chávez R, Chávez-Flor LF
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ABSTRACTObjective. The present treatment has been proposed for those cases in whom chronic extensive wounds have a delayed cicatrization and prone the patients into an underdog way of life, as a result of frequent attendance to hospital and impairment in daily activities. Wound dressing with a processed layer of porcine small intestinal submucosa has the objective to accelerate the ulceration healing, which is advised as a result of the high content in protein, lipid and carbohidrate of its extracelular matrix. Material and methods. One layer of Oasis® as it is known the sterilized intestinal submucosa, is shaped according to the size of ulceration, exceeding in one inch around the contour of the exposed tissue. Layer is reconstituted by saline and applied over the lesion. Wet gauze, nylon tissue and gentile compressive bandage that protect the layer, must be retired every 5 to 7 days to repeat the procedure until complete healing is obtained. Twenty adult cases of both genders aged 36.3 years in average (13 to 82), who had loss of skin in areas from 1 to 20 cm in their greater diameter, most of them in lower limbs, were treated by the present method. Results. Complete healing was obtained in all but 2 patients. The span for treatment varied from one application, which was required in 5 cases, to 14 sessions in one case. Treatment was abandoned by one woman because of intense pain while in transportation as a result of diabetic neuritis, as well as by other one in whom surgical closure was tried upon patient’s request. Final results in those cases of wound healing were excellent. No case of allergenic reaction was observed. Conclusion. Abundance of nutrient resources contained in the matrix of the submucosa layer, enhances the host cells ingrown until epitelizing, which occurs at a speed depending on how deep is the ulceration to be treated. No allergy was evoked in any case since layer matrix is acelular. Significant cost-treatment economy was ensured since the layer applications are performed as an outpatient procedure.